something has gone away

haiseh... disebabkan aku da ponteng class time raya haji.. aku kene rewek plak endocrinology.. malas tul la...rewek lagi.. kali ni.. cikgu kasi aku patient diabetis... da lame da aku tinggal bab2 endo... benci tul la.. aku tak ske tol bab2 endo, hormone2 ni...
tapi patient aku kali ni agak menarik... diabetis mellitus type 1 ... semue complication pon da ade... dari retinopathy, nephropathy,angio-neuropathy tinggal cardiopathy je aku tak sempat check.. hoho.. sian pakcik ni.. mate da kabur2 da tak nampak... nak kencing pon da problem ,
nih ade satu xray kaki pakcik ni sempat aku snap...
tgk right foot die.. pelik kan... bone die semue shift medially...

kalau tere..cube la teke kenape? hoho...
last month dah wat operation.. da remove da tulang2 senget tu.. hehe

lagi satu... utk patient diabetis ni.. on inspection ...kat tapak tangan... slalu dpt reveal -

Dupuytren
ape tu dupuytren?
an abnormal thickening of the fascia (the tissue just beneath the skin of the palm). It often starts with firm lumps in the palm. In some patients, firm cords will develop beneath the skin, stretching from the palm into the fingers
cause of dupuytren ni.. usually kalau ikut cikgu aku.. is idiopathic.. means tatau punce...
tapi usually kalau org tu ade masalah biochemical factor on fascia..
tp mmg slalunye leh nampak kat petient yg ade diabetis ni..
dah la time tu dah kol 4 lebey.. penat da.... aku nak abes kan cepat2.. asal aku tanye soalan kat die.. die asik tanye aku dari mane la, lagi bape taun la.. mcm2 la.. sedar2 nak dekat sejam lebey lepak ng die..
tapi takpela.. sian lak kat die.. cam boring kan.. layan jer..
so far glucose level die dah control ...
harap2 die ok la
slamat...